Radiographic findings in late-presenting congenital diaphragmatic hernia: helpful imaging findings

Abstract

Although not common, late-presenting CDH can result in confusing plain film radiographic findings and a delay in diagnosis. We found that the most important finding in analyzing these radiographs is in evaluating the location and position of the gastric bubble with the more common left-side hernias.

Congenital Diaphragmatic Hernia in an Adult Presenting With Ileus: A Case Report

“…The most commonly used examination is sectional computerized tomography [9,10]. In our case, diagnosis was suspected with direct X-rays and supported with computerized tomography.…”

Diaphragmatic Hernia in a Pediatric Emergency Department

“…Tension pneumothorax and pleural effusion are the most common initial incorrect diagnosis according to CXR, resulting in inappropriate procedures, such as chest tube insertion, and subsequent risk of gastrointestinal perforation. 3,12 Computed tomography scan is recommended to confirm the diagnosis and avoid inappropriate chest drain placement when clinical features raise the suspect of CDH, but CXR findings are incomplete or confusing. Chest radiography after the passage of a nasogastric tube placement or upper gastrointestinal series are alternative methods of confirming the diagnosis.…”

Cardiac Arrest in a Pregnant Patient Diagnosed with Bochdalek Hernia

“…In situations where doubt remains, MR and USG are extremely helpful imaging methods. In such cases the imaging results may be misleading as the findings may mimic acute pulmonary problems such as cavitary pneumonia, pleural effusion, massive pneumothorax, or pneumatocele [7,8]. However, on presentation at the Emergency Department, the diagnosis was not a priority and x-rays and tomography were not applied in order to protect the fetus from radiation.…”

“…This explained the occurrence of the sudden onset of respiratory distress, ischemia, and perforation of the gastric wall. Emergency intervention becomes mandatory in severely symptomatic patients as this condition is associated with high fetal and maternal loss [2,7]. Only about 100 to 150 reports of adult Bochdalek hernia can be found in the literature.…”